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Letters

Reece, Justin, RN; Barker, Beth, RN; Andall, Aquira, RN

doi: 10.1097/01.NUMA.0000557620.35061.cb
Department: Letters
Free
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Staff well-being is a must

In “An Investment in Staff Well-Being” (December 2018), Leigh Hume, MN, RN, writes that healthcare organizations using the Pathway to Excellence® framework implement successful strategies to support their nurses' well-being. Her section on the impact of well-being on patient care gives added emphasis to the need for nursing leadership to take an active role in the promotion and maintenance of nurses' well-being.

I feel this article is especially pertinent to the current state of the nursing profession because of the multitude of stressors nurses face. From understaffed units to overcrowded EDs, nurses are repeatedly asked to do more with less. In addition to these stressors, nurses must cope with the surge of technology that's innervating their practice. Although technology is revolutionizing patient care, the workflow impact of healthcare information and disease-specific management systems can be stressful to nurses of all experience levels.

In my facility, we've recently implemented the use of a diabetes management software application, which has caused a total revamping of the workflow related to our patients with diabetes. Because it isn't fully integrated with our electronic medical record system, this application has also caused an increased documentation load for our nurses at the bedside. As you can imagine, the stress of integrating new technology coupled with workflow changes has strained our patient care teams.

In her article, Hume demonstrates that implementing an innovative, modern, and pertinent framework to promote staff well-being can positively impact patient safety and nurses' health. My hope is that nurse leaders will advocate for well-being, and I applaud your publication for taking an active role in supporting our colleagues' health.

—Justin Reece, RN

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Support for nurses with compassion fatigue

In the article “Conquering Compassion Fatigue: Lessons Learned for the Nurse Manager” (December 2018), Autum Shingler-Nace, DNP, RN, NE-BC; Judith Zedreck Gonzalez, DNP, RN, NEA-BC; and Melanie M. Heuston, DNP, RN, NEA-BC, use experience and research to support the need for effective nurse managers. In their study, information verifying that nurse burnout is high was collected from the pretest, but over half of the nurses dropped out before the posttest. The dropout rate was attributed to leadership transitions, which couldn't support the culture shift that the interventions required.

I agree with the authors' findings, but the nurse leader must be a manager who empowers others to do some of the work to move toward the type of environment needed to sustain a change in culture. There are leaders on the floor who aren't formal managers, and they should be encouraged to influence and care for nurses who are struggling with compassion fatigue. My nurse manager would take me into her office and talk through the things causing me stress, but it was the morning that the unofficial leader on the floor told me she liked taking patients from me because I gave good care and did a good job that I felt empowered.

Caring for nurses with compassion fatigue is a challenge to be met by nurse leaders to keep skilled nurses and support them so they can invest in their patients. Thank you for including this article in your journal. I enjoyed reading it and was challenged by its content.

—Beth Barker, RN

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Zero tolerance for incivility

In “Workplace Incivility: Nurse Leaders as Change Agents” (January 2019), Cheryl Ann Green, DNP, PhD, RN, LCSW, CNE, CNL, MAC, FAPA, highlights the devastating effects of incivility among nurses. Unfortunately, “nurses eating their young” is a common and accepted phenomenon that many nurses are afraid to address. In addition, nurse managers may turn a blind eye to their staff members' interpersonal problems and even partake in bullying behavior themselves.

Nurse managers who choose to ignore the magnitude of incivility and its negative impact on patient safety and nurse retention are doing a great disservice to the nursing profession. I commend the author for her candid but supportive approach to this matter as she holds nurse managers accountable for unit culture. I believe that nurse managers should set the example for their unit, organization, and profession by not allowing incivility to continue. I challenge all nurse managers to take a proactive and democratic approach to incivility while giving employees an open forum to share their job-related concerns without fear of retaliation.

—Aquira Andall, RN

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